Pronation is a term that describes inward rotation of the foot so that more weight is borne on the medial (inside) border. During normal gait, the heel strikes the ground first and weight is then transferred along the arch and toward the ball of the foot. There is a normal degree of pronation that occurs during this process of weight transfer.
When the foot becomes over pronated and rolls excessively inward, the arch collapses and the feet flatten causing the soft tissues to stretch.
Over pronation may never manifest itself into a problem or can lead to some very debilitating conditions. Recognizing the symptoms early and taking preventative precautions will help to keep you off the examining table and on your feet.
Causes
- Genetics
All of us are born with flat feet. Our arches start to develop when we begin walking and may not fully develop until the age of 4.
People who do not develop an arch in their foot have what is called a structurally flat foot that can lead to over pronation.
- Pregnancy
The weight gain experienced during pregnancy changes a woman's center of gravity. This affects her weight-bearing posture adding pressure to the knees and feet.
- Sports
Trauma from stress such as repeated running on hard surfaces can cause the arches to lower and lead to over pronation.
Recognizing The Signs
- Excessive wear on the inside of the shoe
- The heels roll inward (best observed in bare feet) in a standing position
- One or both knee caps turn inward
Chain Reaction
Pronated feet affect alignment of the foot, ankle, leg, pelvis, and back. Therefore, problems can manifest themselves anywhere in the body. Over pronation is also an unstable position of the foot causing increased strain on the muscles and ligaments that can eventually lead to long term consequences.
Common injuries related to over pronation include achilles tendonitis, bunions, heel spurs, metatarsalgia, Morton's neuroma, plantar fasciitis (heel and arch pain), and shin splints.
Low back discomfort as well as hip and knee pain (chondromalacia patella and iliotibial band syndrome) may also occur.
If The Shoe Fits…
Selecting appropriate footwear will help to decrease your chances of developing a problem related to over pronation.
Here are some helpful hints to keep in mind when shoe shopping:
- A shoe with a reinforced heel counter and adequate arch support is recommended to
provide support and stability. In my experience as a physical therapist, New Balance
brand sneakers tend to work well for people who over pronate.
- Tie your shoe laces so that they are snug to increase foot and ankle stability.
- Replace your shoes every 300-500 miles, or sooner, if excessive wear patterns are present.
- Orthotics may be necessary if painful conditions arise. Your physician can refer you to
a podiatrist or orthotist who specializes in making these type of custom made shoe
inserts.
Conclusion
Pronation in addition to a plethora of other postural problems keep physical therapists like myself in business. However, I hate to see anyone in pain, particularly fitness minded individuals whose workout regimens become hampered by annoying aches and pains. Pay attention to those feet and hopefully you won't have to pay a trip to the podiatrist!
Remember: This information is not intended as a substitute for medical treatment.
About The Author
Holly Wilbur is a licensed physical therapist, certified personal trainer, and fitness competitor/model. If you have additional training questions for Holly, she may be contacted through her website at www.hollywilbur.com.
holly@hollywilbur.com
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